Non-Cochrane · intervention · PM42539490
Glucosamine supplementation in the treatment of temporomandibular joint disorders: a systematic review and meta-analysis.
Calzada-Gonzales Nancy, Aguirre-Ipenza Rubén, Serna-Alarcón Victor, et al. · Frontiers in dental medicine · 2026 · PubMed · doi:10.3389/fdmed.2026.1868023
Findings
25 findings
| Population | ||||
|---|---|---|---|---|
| Patients with temporomandibular joint osteoarthritis (TMJ OA) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Placebo | Maximum mandibular opening without pain (mm) 12 months | MD 1.88 [-3.11, 6.87] Very low Downgraded: risk of bias, imprecision 1 study · 26 participants |
| Patients with temporomandibular joint osteoarthritis (TMJ OA) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Placebo | Maximum mandibular opening without pain (mm) 6 weeks | MD 1.80 [-1.32, 4.92] Very low Downgraded: risk of bias, imprecision 1 study · 59 participants |
| Patients with temporomandibular joint osteoarthritis (TMJ OA) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Placebo | Pain (VAS 0-100 mm) 12 months | MD -4.75 [-13.65, 4.15] Very low Downgraded: risk of bias, imprecision, inconsistency 2 studies · 170 participants |
| Patients with temporomandibular joint osteoarthritis (TMJ OA) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Placebo | Any adverse events Not specified (follow-up of included trials) | RR 1.65 [0.79, 3.43] 103 [-33, 385] events per 1000 Very low Downgraded: risk of bias, imprecision 2 studies · 203 participants |
| Patients with temporomandibular joint osteoarthritis (TMJ OA) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Placebo | Pain (VAS 0-100 mm) <=3 months | MD -1.58 [-5.98, 2.83] Low Downgraded: risk of bias 2 studies · 203 participants |
| Patients with temporomandibular joint osteoarthritis (TMJ OA) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Placebo | Pain (VAS 0-100 mm) 6 months | MD -7.02 [-11.95, -2.09] Moderate Downgraded: imprecision 1 study · 144 participants |
| Patients with temporomandibular joint osteoarthritis (TMJ OA) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Placebo | Quality of life (OHIP-14, lower is better) 12 months | MD -4.14 [-6.41, -1.87] High 1 study · 144 participants |
| Patients with temporomandibular joint osteoarthritis (TMJ OA) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Placebo | Serious adverse events Not specified (follow-up of included trials) | RR 3.87 [0.90, 16.70] 57 [-2, 311] events per 1000 Very low Downgraded: risk of bias, imprecision 2 studies · 203 participants |
| Patients with temporomandibular joint osteoarthritis (TMJ OA) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Active control (ibuprofen or tramadol) | Any adverse events Not specified (follow-up of included trials) | RR 0.64 [0.12, 3.46] -49 [-120, 335] events per 1000 Very low Downgraded: risk of bias, imprecision 1 study · 45 participants |
| Patients with temporomandibular joint osteoarthritis (TMJ OA) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Active control (ibuprofen or tramadol) | Pain (VAS 0-100 mm) <=3 months | MD -4.57 [-9.91, 0.77] Very low Downgraded: risk of bias, imprecision 1 study · 39 participants |
| Patients with temporomandibular joint osteoarthritis (TMJ OA) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Active control (ibuprofen or tramadol) | Maximum mandibular opening without pain (mm) 3 months | MD 1.75 [-4.10, 7.60] Very low Downgraded: risk of bias, imprecision 1 study · 39 participants |
| Patients with temporomandibular joint osteoarthritis (TMJ OA) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Active control (ibuprofen or tramadol) | Quality of life (Brief Pain Inventory, lower is better) 3 months | MD -6.74 [-14.70, 1.22] Low Downgraded: imprecision 1 study · 39 participants |
| Patients with temporomandibular joint osteoarthritis (TMJ OA) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Active control (ibuprofen or tramadol) | Serious adverse events Not specified (follow-up of included trials) | RR 0.64 [0.12, 3.46] -49 [-120, 335] events per 1000 Very low Downgraded: risk of bias, imprecision 1 study · 45 participants |
| Patients with other/unspecified temporomandibular disorders (TMD) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or combined) | Placebo | Quality of life | There was no evidence for this outcome on patients with other/unspecified TMD No studies found 0 studies |
| Patients with other/unspecified temporomandibular disorders (TMD) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Placebo | Pain (VAS 0-100 mm) <=3 months | MD 11.00 [-1.05, 23.05] Very low Downgraded: risk of bias, imprecision 1 study · 34 participants |
| Patients with other/unspecified temporomandibular disorders (TMD) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Placebo | Any adverse events Not specified (follow-up of included trials) | RR 1.37 [0.63, 2.95] 118 [-118, 620] events per 1000 Very low Downgraded: risk of bias, imprecision 1 study · 45 participants |
| Patients with other/unspecified temporomandibular disorders (TMD) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Placebo | Serious adverse events Not specified (follow-up of included trials) | RR 6.71 [0.37, 122.83] 130 [-14, 1000] events per 1000 Very low Downgraded: risk of bias, imprecision 1 study · 45 participants |
| Patients with other/unspecified temporomandibular disorders (TMD) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Active control (ibuprofen or tramadol) | Maximum mandibular opening without pain (mm) 3 months | MD 3.23 [0.82, 5.64] Low Downgraded: risk of bias 1 study · 60 participants |
| Patients with other/unspecified temporomandibular disorders (TMD) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Active control (ibuprofen or tramadol) | Pain (VAS 0-100 mm) <=3 months | MD -0.90 [-1.88, 0.07] Low Downgraded: risk of bias 2 studies · 91 participants |
| Patients with other/unspecified temporomandibular disorders (TMD) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Active control (ibuprofen or tramadol) | Serious adverse events Not specified (follow-up of included trials) | Not estimated (0/33 events in both groups) 0/33 (0%) vs 0/33 (0%) Low Downgraded: risk of bias 1 study · 66 participants |
| Patients with other/unspecified temporomandibular disorders (TMD) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or combined) | Active control (ibuprofen or tramadol) | Quality of life | There was no evidence for this outcome on patients with other/unspecified TMD No studies found 0 studies |
| Patients with other/unspecified temporomandibular disorders (TMD) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Active control (ibuprofen or tramadol) | Any adverse events Not specified (follow-up of included trials) | RR 0.31 [0.13, 0.75] -335 [-422, -121] events per 1000 Very low Downgraded: risk of bias, imprecision 1 study · 66 participants |
| Patients with TMD (TMJ OA and other/unspecified TMD combined) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Placebo | Serious adverse events, overall diamond Not specified (follow-up of included trials) · All TMD combined (TMJ OA and other/unspecified TMD) | RR 4.32 [1.17, 15.97] GRADE not reported 3 studies · 248 participants |
| Patients with TMD (TMJ OA and other/unspecified TMD combined) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Placebo | Pain (VAS 0-100 mm), overall diamond <=3 months · All TMD combined (TMJ OA and other/unspecified TMD) | MD 0.84 [-6.04, 7.71] GRADE not reported 3 studies · 237 participants |
| Patients with TMD (TMJ OA and other/unspecified TMD combined) | Oral glucosamine supplementation (sulfate or hydrochloride, alone or with co-interventions) | Placebo | Any adverse events, overall diamond Not specified (follow-up of included trials) · All TMD combined (TMJ OA and other/unspecified TMD) | RR 1.51 [0.96, 2.39] GRADE not reported 3 studies · 248 participants |
Included primary studies 7
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Comert Kilic 2021 Does glucosamine, chondroitin sulfate, and methylsulfonylmethane supplementation improve the outcome of temporomandibular joint… PMID:33685850 | 2021 | 2 other reviews | not stated | not extracted yet |
| Cahlin 2011 No effect of glucosamine sulfate on osteoarthritis in the temporomandibular joints--a randomized, controlled, short-term study. PMID:22001199 | 2011 | 1 other review | not stated | not extracted yet |
| Damlar 2015 Effects of glucosamine-chondroitin combination on synovial fluid IL-1β, IL-6, TNF-α and PGE2 levels in internal derangements of… PMID:25662545 | 2015 | this review only | not stated | not extracted yet |
| Haghighat 2013 Evaluation of Glucosamine sulfate and Ibuprofen effects in patients with temporomandibular joint osteoarthritis symptom. PMID:24991602 | 2013 | this review only | not stated | not extracted yet |
| Nguyen 2001 A randomized double-blind clinical trial of the effect of chondroitin sulfate and glucosamine hydrochloride on temporomandibular joint… PMID:11842864 | 2001 | this review only | not stated | not extracted yet |
| Thie 2001 Evaluation of glucosamine sulfate compared to ibuprofen for the treatment of temporomandibular joint osteoarthritis: a randomized double… PMID:11409130 | 2001 | this review only | not stated | not extracted yet |
| Yang 2018 Oral Glucosamine Hydrochloride Combined With Hyaluronate Sodium Intra-Articular Injection for Temporomandibular Joint Osteoarthritis: A… PMID:29864430 | 2018 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children or adults with any type of TMD, including TMJ OA | Adults with TMJ OA (4 RCTs) or other/unspecified TMD (3 RCTs); 393 participants |
| Intervention | Oral glucosamine in any formulation or as part of a co-intervention | Glucosamine sulfate 1200-1500 mg/day (4 RCTs) or hydrochloride 1440-1500 mg/day (3 RCTs), some with chondroitin, MSM or hyaluronic acid |
| Comparison | Placebo, standard management, no treatment or active comparator | Placebo (3 RCTs), active control ibuprofen or tramadol (3 RCTs), hyaluronic acid injection standard care (1 RCT) |
| Outcomes | Pain; maximum pain-free or comfortable mandibular opening; quality of life; maximum pain-independent opening; adverse and serious adverse events | Pain, quality of life, maximum pain-free mandibular opening, adverse events, serious adverse events |
| Study designs | Randomized clinical trials | RCTs (n=7) |
| Timing | Follow-up of at least 1 month | 3 months or less (6 RCTs), 6 months (1 RCT), 12 months (2 RCTs) |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Yes | Partial Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | Yes | Yes | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Low | yes |